Throwing Velocity and Patient Reported Outcomes in Elite Level Handball Players After Completion of Shoulder-Pacemaker Strength Training

Sportorthopädie Zentrum in Wien Hietzing14 enrolled

Overview

The successful application of treatment protocols using motion-triggered neuromuscular electrical stimulation (NMES) for treatment-resistant functional posterior shoulder instability was recently demonstrated. The purpose of this study is to evaluate the concept of a motion-triggered NMES training protocol through objective clinical outcome parameters and its impact on external rotational (ER) shoulder strength and throwing velocity in healthy, elite-level handball players.

The aim of this study is to evaluate the concept of a motion-triggered NMES training protocol through objective clinical outcome parameters and its impact on external rotational (ER) shoulder strength and throwing velocity in healthy, elite-level handball players. It is hypothesized that a 6-week motion-triggered NMES shoulder strengthening training protocol in elite-level handball players would lead to an increase in throwing velocity due to an improved motor ability and ER shoulder strength.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

Conditions

Shoulder Dislocation

Interventions

Experimental group subjects undergo a motion-triggered NMES shoulder strengthening training program (3x/week, 30 minutes for 6 weeks) using the Shoulder Pacemaker (NCS Lab Srl, Modena, Italy), a motion activated stimulation device to strengthen muscular disbalances. This is accomplished through varying neuromuscular electrical stimulation intensity based on the angle of motion of the arm producing subtetanic contraction and provoking supraspinal neural adaptations. Electrode placement: electrode 1, inferior to the scapular spine (infraspinatus, teres minor, + posterior deltoid); electrode 2, medial to the medial scapula border (lower trapezius + rhomboids) . Sets x repetitions: 3x20 Levels: Level 1-3; Exercise 1: L1: Supported row, L2: Front raises in 45°, L3 Front raises (thumbs up) Exercise 2: L1: Resisted front raises, L2: Crossbody resisted raises, L3: Crossbody; forehand swing; Exercise 3: L1: Rear dealt fly, L2: Single arm resisted row, L3: Underhand volleyball

Eligibility

Sex: MALEMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Elite level handball players healthy and actively competing at the time of the study * Patients must be at least 18 years at the time of signing the informed consent * Pregnancy must be ruled out in the case of female participants (e.g., pregnancy test) * Patient must be available for all specified assessments throughout the study duration * All patients are required to give written informed consent before enrollment Exclusion Criteria: * age \<18, * history of type I or II shoulder instability according to the Stanmore classification12, * existing pain syndrome (defined by pain at rest or during motion that is not caused by dislocation and impedes training), * recent shoulder surgery (\<1 year). * Contraindication to SPM treatment (e.g., cardiac pacemaker) * Neurological disorders or nerve injuries causing the instability * Uncontrolled alcohol or substance abuse

Outcomes

Primary Outcomes

Throwing velocity (km*h-1)

the difference in throwing velocity (km\*h-1) from baseline to 6-week post-intervention follow-up.

Time frame: Baseline to 6-week post-intervention follow-up.

Secondary Outcomes

Isometric hand-held dynamometer (HHD) ER and internal rotation (IR) maximal shoulder strength

Secondary outcome was the difference in isometric hand-held dynamometer (HHD) ER and internal rotation (IR) maximal shoulder strength at final follow-up.

Time frame: Baseline to 6-week post-intervention follow-up